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Individual

MRS. TRACY GANES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
10 E HOSPITAL STREET, ANESTHESIA DEPARTMENT, MANNING, SC 29102
(803) 435-8463
Mailing address
10 E HOSPITAL STREET, ANESTHESIA DEPARTMENT, MANNING, SC 29102
(803) 435-8463

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN2641
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2641
LICENSE
SC
05
AN1441
SC
Enumeration date
03/24/2006
Last updated
11/19/2014
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